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Reflections on the one-year anniversary of my anxiety post, including thoughts on how to support students with anxiety

One year ago, I was sitting at my computer, working on a post in which I talked* about having an anxiety disorder. My hope was that, by being open about having an anxiety disorder, I could help reduce some of the stigma associated with mental health problems, be a more vocal advocate for mental health in academia, and could help other academics with mental health issues know that they are not alone and that help is available and worth seeking. I think the post succeeded in those goals.

Below, I talk more about how people responded, give my thoughts – as well as some crowdsourced from twitter – on how to be a good colleague or advisor to someone with anxiety, talk about ongoing bias against mental health issues in academia and how that might affect early career folks, and summarize some of the key messages that I think are most important related to mental health, anxiety, and academia.

One thing people have asked about is what it was like after my post— did anything change? This quote from this NYTimes piece on “coming out” with an anxiety disorder sums things up pretty well: “for the most part people didn’t seem to treat me any differently — and to the extent that they did, it was to express sympathy or empathy and even admiration”. Mostly, there have been no indications that most of my faculty colleagues are aware of the post (and, for many, that is probably because they aren’t aware of it!) Since writing the post, a few colleagues have responded by asking me how to be more sensitive to mental health issues that students are facing, which is great! (Part of my goal, as I said above, was to increase dialogue about this topic.)

The most notable change was a personal one: writing about having an anxiety disorder was incredibly freeing. One of the things I tended to get most anxious about was whether people would realize I had anxiety. So, by being open about having anxiety, I removed a major source of anxiety. That’s not to say I’ve been anxiety-free in the past year! That will never be the case, nor would that be a good thing. But it has made me feel much freer to tweet about mental health topics, to bring them up in my department and my classroom, and to admit to colleagues at a meeting that I’m going back to the hotel to sleep because I really need to for my mental health. And that, on it’s own, reduced anxiety.

By being open about having a mental health problem, some colleagues have asked: How can someone be a good colleague or advisor to someone with anxiety? (This question also came up on twitter.) I think that one key thing is to remember is that there can be a lot going on below the surface that isn’t apparent to others – people often work hard to hide that they have anxiety (or depression or OCD or bipolar disorder or whatever). To refer back to that same NYTimes piece (which I think is a really good account of what it can be like to live with anxiety), “I generally did everything I could to project an aura of competence and confidence that was often at odds with the vulnerability, and sometimes the terror, that I felt.” This was me, 100%. Mental health problems are really, really common in academia, so the odds are good that several of your colleagues and students are dealing with them. And they may not be the people you would guess – I’ve had multiple colleagues say things to me over the years like, “Well, not everyone is as confident as you are”, implying that I couldn’t possibly understand the self-doubt and worry a student was experiencing. However, while someone with anxiety may be good at hiding things, there is stuff going on under the surface, and sometimes it will bubble up. So, remember that there’s a chance that the colleague who sometimes cancels meetings at the last minute (which can be frustrating!) or the student who misses a deadline with a vague excuse might be overwhelmed by anxiety or depression at that time. Be kind. Assume that people who ask for accommodations need them. Be flexible. (As just one example: your student might need to move a meeting because their therapist’s availability shifted and they needed to reschedule an appointment, but they might not want to explain all that to you.) Be clear about expectations. Be specific (including in your emails!) Mentoring plans can help a lot with having conversations about specific expectations and whether a lab member is meeting them. Mentoring plans can also help a student come up with a way to split a big project up into smaller, more manageable tasks. Having structure in one’s schedule helps a lot (and means that, for many academics, summers can be hard, due to the lack of structure). Call out colleagues who say things like “He’s crazy” or “She cried in my office – I know she was just trying to get a better grade”.

With people (especially students) who are open with you about having a mental health issue, ask about whether there are changes that you can make that might better support them (e.g., are there particular triggers that could be avoided?) Realize there will be setbacks, and support their recovery from them. Celebrate the small victories! Listen. Brainstorm options if they’re looking for ideas. If they bring up a mental health concern, don’t try to change the subject and don’t simply say that everything will be fine or that it’s not a big deal. Help them find support. Give specific positive feedback. When you give negative feedback, again, be specific, preface it with positive feedback if possible, and try to check back in later in the week to see how things are going. Have regular lines of communication and regular (low stakes) meetings, but, as I said above, be flexible if those need to be moved around. Minimize surprise tasks. Give them space if they need it. Make it clear through your actions and words that people are encouraged to have interests outside work, and that it’s not healthy to work super long hours. (This will help everyone work better, not just those with mental health issues!) And, for Pete’s sake, don’t indicate (through your words or actions) that having a mental health problem means they cannot succeed in academia. **

To throw out a few other ideas that people have found help them: lists that break tasks up into smaller, more manageable tasks, action plans, sayings/mantras they can employ in certain triggering situations, building a support network, and group-writing sessions to get around anxiety-induced writer’s block.

I’ve tried to encourage more dialogue by posting this flyer (inspired by a similar one made by Catherine Scott, who got the idea from here) on my office door:

But I think it’s important to recognize that, even while being open about having a mental health issue myself and while doing everything I can to signal that I will not judge people for mental health issues, I know that many will choose not to reveal mental health problems. Which brings me to my next point:

For me, talking about having anxiety has been, at worst, neutral and, at best, personally beneficial. I was concerned that some might treat me with kid gloves, but that hasn’t happened. I hoped that it might open the door to more dialogue about mental health issues; that has happened. But I realize that some of why it’s been positive for me is because I have a position of huge privilege – including having tenure at a prestigious university and the financial security and stability that come along with that. There is, unfortunately, still a lot of bias against mental health issues in academia. People choose whether or not to disclose mental health issues for a whole variety of reasons — only one of which is how they think you might react. Given the stigma associated with mental health, a lot of people will, quite reasonably, choose not to disclose a mental health issue.*** So, coming back to what I said above: remember that there is often a lot of stuff going on below the surface, and be kind.

To summarize what I think are some of the key points to emphasize related to mental health and academia (please feel free to suggest others in the comments!):

If you are feeling overwhelmed or very unmotivated or are crying regularly or just generally feel pretty stressed out, please consider seeking out help from your doctor or a therapist or a counseling center! Seeking help is a sign of strength, not weakness! (I still think this comic does a great job of conveying the strength of people who seek out help when they are battling depression.) When people ask me about whether they should seek help, I tend to say that, if you are even considering seeking help, it’s probably worth doing so. Our society, unfortunately, sends us lots of signals that we should not seek help; so, if you are considering it despite those societal messages, I think that’s significant and worth following up on.

If you feel overwhelmed and aren’t sure who to call, seek help by asking a trusted friend, family member, faculty or staff member, clergy, or anyone else you trust) to help you. When you are in the thick of it, it can be hard to figure out how to find help. Please believe me when I say that there are people in your life who want to help you. If you think that is not true, remind yourself that that is your depression (or other mental health issue) telling you that.

We need more senior folks who have privilege to discuss mental health more openly. Clearly the decision of whether to disclose a mental health issue is a deeply personal one, and I’m emphatically not saying that everyone should. But if you are fortunate enough to be in a position where you can be a mental health advocate with few or no consequences, please consider whether you might want advantage of that to talk more openly about being an academic with a mental health issue.

Everyone – regardless of whether they have any personal experience with a mental health issue – needs to call out language that stigmatizes mental health. The stigma is so deep in society that this can be hard. This post has some ideas for how to avoid using “crazy”, “insane”, etc.

You should absolutely not use something that is a medical diagnosis (e.g., “bipolar”, “OCD”) as an insult. (Note: based on a conversation on twitter, I think my point here wasn’t totally clear, so let me try again: It is not okay to use language like “She’s bipolar” as an insult. It is fine to have bipolar disorder. There are really effective treatments for bipolar disorder and, even though you don’t know it, you have colleagues and students who have bipolar disorder and who are doing fantastic jobs as scientists (and living fulfulling daily lives). And that’s just using bipolar disorder as one example. My point is: mental health disorders are health issues that can be treated and managed. They are not insults. Do not use mental health labels as pejoratives.)

People with mental health issues can succeed in academia. Please don’t let anyone convince you otherwise!

* I originally typed “admitted”, which is probably noteworthy. There is still a big stigma associated with mental health.

** Some of the ideas in this paragraph and the following one were crowd-sourced fromtwitter!

*** One conversation I had recently centered related to whether to disclose a mental health disorder in a diversity statement for faculty applications. Different people will reach different conclusions about this, but my take was that it might be better to just talk generally about having seen fellow graduate students who needed more support for mental health.

14 thoughts on “Reflections on the one-year anniversary of my anxiety post, including thoughts on how to support students with anxiety”

While I fundamentally agree with many of the things you say here and applaud you for them, I miss the reflection about why people in academia are having these issues and what we can do to fix them. Recognizing the issue is a huge step to solve it, but there is much more to do, like understanding why and if it was/is/will be avoidable by changing the way we think and act.
To me, it is simply not enough to accept that people have anxiety in academia and leave it there. We need to know why this is so common in academia (I think we know it already!) and work to change those bad habits that led perfectly healthy people to such a dramatic disorder…
Mental health problems are frequently related to our lifestyle and not to an intrinsic organic failure so, yes, let´s remove the stigma but, most importantly, let´s remove the cause!
P.S. Of course, this is from someone who, like more than 50% of people in academia, had to go through important mental health problems…

I also fundamentally agree with what is being said here, but I have another opinion too that may not be as popular. While no one should have to suffer for any reason, there is a difference between having struggled with a dibilitating mental illness for your entire life (such as bipolar disorder or schizophrenia) and having ended up with a job that is high pressure and makes you miserable on a daily basis. Anyone, faculty or student, who is struggling mentally should get help (and deserves it) regardless of the reason, but I have to say that nowadays that both these things are grouped into the broad category of ‘mental illness’ really is insensitive. The two things are perhaps distantly related but not the same. Not by a very long shot. As someone in the former category I can vouch for that. Just something else to be sensitive about when discussing ‘mental illness’ in a classroom or work setting.

That sounds very reasonable and like you say there are several things here that could only be distantly related and that can have different origins…
But of course the fact that in academia there is a greater than average risk of suffering mental health problems points out to the existence of habits that can be changed. And everyone will benefit from these changes, both people who had mental illness before and those who did not but found themselves in an unhealthy environment.

I don’t have anxiety disorders so I don’t know if any if these suggestions will work but ill just put them out there…

If work feels overwhelming, step back and ask yourself why you came this far. Hopefully and probably its because you’re interested in what you’re doing. So focus the interest of doing the work rather than either the ultimate goal of a final product or whether its groundbreaking or whatever other external factors might bum you out.

In the much larger picture, don’t get lost in worrying about failure – and in doing so create it. No one thing you doin life will determine the final outcome. The world is a surprisingly forgiving place.

And they may not be the people you would guess – I’ve had multiple colleagues say things to me over the years like, “Well, not everyone is as confident as you are”, implying that I couldn’t possibly understand the self-doubt and worry a student was experiencing.

True facts: my advisor cheerfully told my thesis defense committee that I “handled criticism really well, so don’t worry!” shortly before the thesis defense where I had been falling apart from terror and self-doubt for the previous month. (I do in fact handle criticism well! I handle it much better than I handle praise, because I am constantly self-criticizing and scrutinizing my flaws, which is by the way not always great for confidence. Hooray!) It all came out okay in the end, but sometimes you are not going to know who is dealing with panic issues because they are going to be so heavily convulsing with shame they will actively be hiding it. Especially because you don’t know who might have punished them for disclosing before.

And this is an advisor who generally does a really good job of following the recommendations on your list: he’s very enthusiastic and supportive of hobbies and makes a point of mentioning his own hobbies outside the lab, he explicitly expects forty-hour work weeks, he holds weekly one-on-one meetings to keep lines of communication open through private as well as public channels, etc. Even if you’re outright watching for things like this, slip-ups are going to happen, because handling people struggling with mental health can be really, really difficult–especially in a profession like academia that is going to be brutal for anyone’s mental health because it’s a genuinely difficult job. It just is. There’s too much failure and rejection built into the job, not much positive feedback, not much structure especially the higher you go, relatively few direct rewards–and I’m saying that as someone who fucking loves my job! It’s hard on the mind if you don’t have support systems built up.

Add in the fact that abusive advisers exist and that some PhD students and postdocs will have had deeply punishing experiences from PIs specifically in the past, and you’ve got a recipe for PIs in particular trying to manage folks with mental health issues without necessarily having all the information to make that possible… and the folks being managed may not necessarily have the trust that would allow actually talking about what they are going through. One of the most important things you can do as a leader is be open to junior people around you about mental health, because that acts as a very important green flag that can build the trust necessary for struggling juniors to tell you what is going on so you can help.

I feel the same way after ‘coming out’ about my mental health condition. I’ve found that some of my colleagues in the education sector view anxiety and depression as weaknesses. It is astounding that some people still feel this way, especially considering the huge push on mental well being in UK schools.

Thanks for raising this issue of mental health. It is so important in our work and our personal lives. Every semester, about 1 in 10 students in my classes exhibits some type of mental health issue, and a number of people in my personal life have grappled with mental health problems. When I encounter people around me who are dealing with mental health issues, I try to be kind and supportive, and sometimes suggest that they seek help. For students in my classes, I direct them to the appropriate university office or clinic for help.

From what I have seen, in many cases (particularly if the mental health issue is situational) that if people can get some rest and support, they can get back on track within a few weeks or months. For people with more long-term depression and anxiety, if family members, co-workers, and friends are supportive and understanding, then they can do much better.

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